Around 20 women sat in rows underneath the shade of a nearby tree using their bare arms as blenders during the kneading process of making shea butter.
These women were just some of the 16 million women across Africa involved in collecting and processing shea. The process starts with the women who pluck the shea fruit from trees, competing with snakes who feed on the shea fruits and risking snake bites.
After peeling the fruits, the remaining nuts are sold to processing centers like this one where the nuts are washed, crushed, roasted, kneaded, and boiled. The entire process of creating shea butter, from the green fruit to the creamy yellow butter, can take around three to four days, according to Cynthia Doubureh, 26, a packaging officer at the Tiehisuma Shea Butter Processing Centre.
The price of shea butter was around $1.50 per two pounds and three ounces in the past, which is around GHC 6 per one kilogram, according to Doubureh, but prices fluctuate.
“Prices are determined by markets for those products and subject to numerous factors including location, time of the year, production of trees, global demand,” said Perkins in an email.
The GSA is a non-profit which aims to eliminate the middle-man between corporations who want the shea butter and the women who are processing it.
Oftentimes women who are picking the shea “are being exploited by private buyers who count on the ignorance of women on the price of the nuts in the world market,” said Dr. Wolfram Laube to Ghana Web.
“Our objective is to empower women’s groups through the provision of warehouses and business development training so they can achieve greater profit in the supply chain,” said Perkins, who has been the communications manager at GSA for one year.
In addition to ensuring women are earning their fair share of the profits, the GSA plans to take part in the conservation effort of shea trees to keep the industry alive.
“The decline of tree populations in Africa is a serious issue and a threat to the long-term sustainability of shea,” said Perkins.
To conserve and grow trees that can quickly bear fruit, the non-profit is teaching women how to attach branches from grown trees to younger trees. This method, called grafting, helps trees bear fruit in two to five years, compared to 20 without grafting, explained Aaron Adu, also of the GSA.
The industry has untapped potential for exports in African countries with shea. About 650,000 tons of shea kernels are processed, while 40 percent are exported.
This is a theme across all of agriculture. Instead of exporting shea and other readily grown food products, Ghana has a high food import bill.
The goal is to cut down on the food import bill, according to Nelson Akatey, 49, a public relations officer at the Ministry of Agriculture. The ministry wants to “create an environment that will promote the sector [of agriculture].”
But to promote the sector, specifically in shea, it must start at the root of production with the women. At the processing centre, one woman, wearing an orange and purple dress, kneaded the shea butter with her arm, smooth from the shea butter, while simultaneously breastfeeding her toddler girl. After, the woman laughed and cooed to keep her daughter entertained while stretched out on a piece of cardboard.
Lawrence Hadzor sat in passenger’s seat of a car on a Monday evening. Suddenly, the front tire flew off, and the car somersaulted across the road. Hadzor had to be rushed to two different hospitals before being told he would need back sugery.
Typically, surgery seems inescapable, but in Ghana, Hadzor was able to opt for another common healthcare option: herbal medicines.
“I couldn’t talk to you like I’m doing now,” he said, describing his pain following the accident. He sat almost upright in his bed at Aponche Memorial Herbal Clinic in Tema, a suburb about 30 kilometers west of Accra.
The clinic has been reputable for its herbal bone setting techniques since the early 1970’s, but herbal remedies have been a part of Ghanaian lifestyle for centuries. Ghana’s colonial past caused herbal medicines to be cast aside among the elites, but in recent years, herbal medicines have evolved into what academics coin as ‘neo-herbalism.’
In a country where a majority of people use herbal medicines, it’s no surprise that Hadzor turned to a sector of the healthcare industry that is more accessible, available, and affordable. The average income in Ghana is $4,200, according to 2014 estimates, so less expensive medicines are an important factor.
Hadzor said he had no problem with surgery, but would rather avoid the risks of surgery if herbal medicines could heal him instead. Three weeks later, he can bend over and almost stand up straight. His back is wrapped in bandages with a powder-water mixture and balm, rubbed over his upper-back.
This old way of bone setting is merging with technological advancements. When Aponche first opened, herbalists set the bone without looking at an X-ray, but now, their medical practitioners are now trained to read X-ray scans the patient brings from hospitals with western techniques.
“While the world is advancing, you need to improve upon what you are doing,” said Isaac Nyankom, 47, son of the clinic’s founder.
Looking towards the future, Aponche wants equipment to diagnose diabetes, take X-rays, and prepare their medicines at the clinic. They also treat health issues like high blood pressure with Bitters, malaria and typhoid with Malamix, and menstrual pains and anemia with Tonic, all around $2 per bottle.
Before these medicines go on sale, they go through an extensive testing and approval process. The medicines are tested for safety and efficacy at the Centre for Scientific Research into Plant Medicine, the primary research center and clinic tucked in the mountains around 45 kilometers north of Accra.
The test results are then taken to the Food and Drug Authority to be officially approved. Without this approval, the medicines are illegal.
The centre, funded by the Ministry of Health, promotes herbal medicines with science, says Baffour Osei Akoto, 33, the centre’s spokesperson.
“It’s not enough that you’re mom took it, and therefore it should work for you,” he said. “We have no shame in admitting that [local herbalists] are our primary sources” for the medicines we test, but there needs to be scientific back up.
And science is what’s pushing this industry forward and legitimizing old folklore medicines with clinical proof. The phytochemistry lab is one of the three main departments at the centre, where researchers spend their days extracting chemical constituents, like alkaloids, flavonoids, and saponins, from the plant materials.
The constituents are “responsible for the therapeutic” qualities, said Henry Daniels, 37, who isolates individual constituents in plants for rat testing.
The chemical constituents make up the ‘concentrated crude extract,’ which make up bottles of liquid medicine sold to people in the clinic. While there are herbal medicines used for malaria, typhoid fever, and piles, some patients rely on them for less severe, day-to-day ailments, similar to American reliance on Tylenol for body pains.
Philip Sajyei, 36, uses a medicine called Herbal Queen for back and waist pains from long days driving through bumper-to-bumper traffic in his taxi. He buys it for under $1.50.
“As soon as I drink it, I see a difference,” he said. Another driver introduced the medicine to him, and since then, he keeps a bottle handy for when he has body pains.
Others, like Linda Osei, 27, try different options, depending on the severity of the problem.
While tending to a trickle of customers at Grace Home Shopping Centre north of Accra, Osei explained that when she gets sick, she first prays. Then, she mixes together certain plains nearby her home to create a remedy. If the herbal mixture doesn’t work, she goes to a hospital.
In Ghana, people “shop around,” depending on their education, religion, what the problem is, and the economic situation, said Kodjo Senah, 65, a medical anthropology professor at University of Ghana, where he researchers traditional medicine.
It’s about trying different things, whether western medicines, herbal medicines, or spiritual remedies, until finding what works for each person.
“Your system is like a radio,” said Iddi Jilma, 23, a dancer and traditional African costume designer who lives in northern Ghana. “You can turn to a certain frequency and it is not clear.”
Jilma only uses herbal medicines. When he’s sick, he sees a local herbalist in his village or makes his own remedy from knowledge passed down from his father.
“Sometimes when you are sick, you try to tune your system to different treatments,” he said.
With herbal medicines on the rise across demographics, the Traditional and Alternative Medicine Directorate and the Traditional Medicine Practice Council have collaborated to open herbal medicines into regional hospitals.
The idea of integrating herbal medicine services into regional hospitals started in 2010, according to Josephine Owusu-Sechere, 40, an administrative officer in the directorate. Since then, 14 regional hospitals have opened herbal medicine branches, with another in progress.
While many people continue to mix their own remedies or seek out local herbalists, the hope is that these branches will continue to legitimize and standardize herbal medicines.
“Herbal medicine is growing at top speed. There is a need for upgrade and technology in our current world,” said Divine Otuo Acheampong, 25, graduate of Kuame Nkumrah University of Science and Technology, home of Ghana’s only four-year program for herbal medicines.
Because plant knowledge passed down along generations is a huge source of medical care for Ghanaians, the efforts to merge medical technology with ancient medicines are an important step for Ghana to show the world what they can offer in healthcare.
“We are trying to marry the modern way of doing things medically and combining it with the herbal medicines we have,” said Sandra Boakye-Yiadom, 29, the general manager at Aponche. Accomplishing this well “will change the mindset about herbal medicines.”